In a hospital setting, a central pharmacy receives medications in bulk and dispenses them to individual patients. Unlike retail pharmacies, the medications in a hospital pharmacy generally are not dispensed in individual pill bottles with labels bearing patient names. Rather, the medications are carefully meted out by the pharmacy staff and sent to nursing stations where the nursing staff stores the medication until such time as the patient is ready to receive the medication.
Typically, the nursing staff verifies the patient identity and patient records prior to dispensing the medication to individual patients. In some hospitals, the patient wears a bar-coded bracelet. The staff reads the bar code on the bracelet with a hand held bar code reader. From the information encoded in the bar code, patient information can be accessed, including medication dosages and schedules. The nursing staff then administers the medication to the patient. In other hospital settings, the bar coded information may be affixed to patient records (e.g., on a clipboard) near the hospital bed.
One drawback to this approach is that, although the pharmacy staff exercises extreme care in dispensing medication, and elaborate safeguards are in place to assure the correct medication is dispensed by the pharmacy staff, a “loss of custody” risk still exists as the medication transits from the hospital pharmacy to the individual patient. For example, in many instances, the pharmacy staff may dispense medication on trays or into paper cups destined for the patient. Such an uncontrolled chain of custody is fraught with risks of loss, mix-ups, inadvertent swapping, and intentional swapping (e.g., theft).